Long Ye, Wang Tong, Liu Jiaxin, Duan Xin, Xiang Zhou
Department of Orthopedics, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P.R.China.
Department of Orthopedics, West China Hospital, Sichuan University, Chengdu Sichuan, 610041,
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2019 Jun 15;33(6):662-665. doi: 10.7507/1002-1892.201812121.
To investigate the effectiveness of recombinant human erythropoietin (rHuEPO) combined with iron in treatment of anemia in elderly patients with intertrochanteric fractures during perioperative period.
A clinical data of 71 patients with intertrochanteric fractures met the inclusion criteria between April 2016 and October 2017 was retrospectively analyzed. All patients were treated with closed reduction and proximal femoral intramedullary nail fixation. Thirty-one patients were treated with rHuEPO and iron before operation as trial group, and 40 patients were not treated with rHuEPO and iron as control group. There was no significant difference in gender, age, body mass index, cause of injury, fracture side and classification, American Society of Anesthesiologists (ASA) classification, combined medical diseases, time from fracture to admission, preoperative hospital stay, and operation time between the two groups ( >0.05).The hemoglobin levels before operation and at 1, 3, and 7 days after operation, number of blood transfusion, blood transfusion rate, blood transfusion volume, postoperative hospital stay, complications were recorded and compared.
After operation, 8 patients (25.8%) in trial group and 22 patients (55.0%) in control group received blood transfusion; the blood transfusion volume was (1.96±0.85) units in trial group and (3.19±1.61) units in control group. There were significant differences in blood transfusion rate and volume between the two groups ( <0.05). There was no significant difference in preoperative hemoglobin level between the two groups ( >0.05). The postoperative hemoglobin level was higher in trial group than in control group, and the difference between the two groups was significant at 7 days ( <0.05). The postoperative hospital stay was (6.16±3.97) days in trial group and (9.25±4.47) days in control group, showing significant difference between the two groups ( <0.05). There were 8 patients (25.8%) with pulmonary infection in trial group and 14 (35.0%) in control group after operation; 6 patients (19.4%) with deep venous thrombosis in trial group and 8 (20.0%) in control group. There was no significant difference in the incidences of complications between the two groups ( >0.05). All patients were discharged from hospital normally, and no one died during hospitalization.
The application of rHuEPO combined with iron before operation in elderly patients with intertrochanteric fractures can rapidly increase the hemoglobin level after operation, shorten the hospital stay, and do not increase the risk of deep venous thrombosis after operation.
探讨重组人促红细胞生成素（rHuEPO）联合铁剂治疗老年股骨粗隆间骨折患者围手术期贫血的疗效。
回顾性分析2016年4月至2017年10月期间71例符合纳入标准的股骨粗隆间骨折患者的临床资料。所有患者均采用闭合复位股骨近端髓内钉内固定治疗。31例患者术前接受rHuEPO联合铁剂治疗作为试验组，40例患者未接受rHuEPO联合铁剂治疗作为对照组。两组患者在性别、年龄、体重指数、受伤原因、骨折侧别及分型、美国麻醉医师协会（ASA）分级、合并内科疾病、骨折至入院时间、术前住院时间及手术时间等方面比较，差异均无统计学意义（>0.05）。记录并比较两组患者术前及术后1、3、7天的血红蛋白水平、输血例数、输血率、输血量、术后住院时间及并发症发生情况。
术后试验组有8例患者（25.8%）输血，对照组有22例患者（55.0%）输血；试验组输血量为（1.96±0.85）单位，对照组为（3.19±1.61）单位。两组患者输血率及输血量比较，差异有统计学意义（<0.05）。两组患者术前血红蛋白水平比较，差异无统计学意义（>0.05）。试验组术后血红蛋白水平高于对照组，两组在术后7天时差异有统计学意义（<0.05）。试验组术后住院时间为（6.16±3.97）天，对照组为（9.25±4.47）天，两组比较差异有统计学意义（<0.05）。术后试验组有8例患者（25.8%）发生肺部感染，对照组有14例患者（35.0%）发生肺部感染；试验组有6例患者（19.4%）发生深静脉血栓，对照组有8例患者（20.0%）发生深静脉血栓。两组患者并发症发生率比较，差异无统计学意义（>0.05）。所有患者均顺利出院，住院期间无死亡病例。
老年股骨粗隆间骨折患者术前应用rHuEPO联合铁剂可使术后血红蛋白水平迅速升高，缩短住院时间，且不增加术后深静脉血栓形成风险。
